Association between placental location and occurrence of preeclampsia in pregnant women referred to Kosar Hospital in Qazvin

Introduction: Preeclampsia refers to high blood pressure and protein in the urine after the 20th weeks of pregnancy. Some studies show that the location of the placenta in pregnancies can predict the occurrence of preeclampsia, preterm delivery and fetal growth restriction. The present study was performed aimed to investigate the relationship between placental site and occurrence of preeclampsia. Methods: This cross-sectional and prospective study was performed in 2019 on 325 pregnant women with 18 to 22 weeks gestational age in Kosar Hospital in Qazvin. Questionnaire information included placenta location, gestational age, neonatal sex, fetal growth restriction, and preterm delivery. Then, the location of the placenta was determined by ultrasound and the placenta with anterior, posterior, and fundus positions was included in the central group and the right and left lateral placenta in the lateral placenta group. Data were analyzed using SPSS software (version 22) and chi-square and logistic regression tests. P<0.05 was considered statistically significant. Results: The fundal placenta compared to the anterior placenta reduced the incidence of fetal growth restriction (P=0.044). The posterior placenta compared to the anterior placenta increased the incidence of preterm labor (P=0.041). In the present study, there was no significant relationship between placental location and the occurrence of preeclampsia (P= 0.680). Conclusion: Ultrasound to determine the location of the placenta in the first months of pregnancy can predict the occurrence of pregnancies prone to preterm labor and fetal growth retardation, but placental location cannot be predictive of preeclampsia

Association of social jetlag with gestational diabetes: Qazvin Maternal and Neonatal Metabolic Study

The association of social jetlag (SJL), as a quantitative measure of circadian misalignment, with insulin resistance and metabolic syndrome has been reported. The present study was designed to investigate the association of SJL with gestational diabetes mellitus (GDM). Pregnant women with gestational age ≤14 weeks were enrolled in this longitudinal study. The participants with pre-GDM, shift workers and those who used alarms for waking up on free days were excluded from the study. SJL as well as behavioral and psychological parameters were evaluated at enrollment. The participants were categorized based on each 1-h increment of SJL. The association of SJL with the occurrence of GDM in the late second trimester was evaluated using univariate and multivariate methods. In total, 821 pregnant women entered the study, and after omitting individuals with excluding criteria, analyses were performed on 557 participants. The frequencies of SJL < 1 h,1 ≤ SJL < 2 h and SJL ≥ 2 h were 44.7%, 37.2% and 18.1%, respectively. Average sleep duration was higher in SJL < 1 h compared with the two other groups (p < 0.001). During follow-up, 90 (16.1%) women with GDM were identified. SJL ≥ 2 h was associated with a 4.4-5.6 times higher risk of GDM in different models of adjustment (p < 0.05). Pregnant women with high SJL are at a higher risk of GDM. Further studies for evaluating the mechanisms by which SJL affects GDM are warranted

Advanced secondary abdominal pregnancy: A complication of induced abortion

Introduction: Secondary abdominal pregnancies usually develop as a result of a tubal abortion, tubal rupture or uterine rupture with intraabdominal implantation. Case Report: We report a 40-year-old patient gravida IV, para III suffering from abdominal pain. She was in the 29th week of gestation according to a 14thweek normal sonogram. She had unsuccessfully attempted to induce abortion with the assistance of a home midwife in the 14th week. This caused severe abdominal pain, but she chose not to be hospitalized because of fear of prosecution. Ultrasound demonstrated that the fetus was out of the uterus and revealed a heterogeneous mass in the left lower quadrant. Laparotomy revealed an area of thin fibrotic scar behind the uterus with normal tubes and ovaries. The fetus in the amniotic sac was surrounded by intestinal loops. The placenta, implanted behind the left broad ligament at the edge of the scar area was removed with a brisk bleeding, which was controlled. No postoperative complications were observed. Conclusion: Presence of little free fluid and a uterine scar with normal fallopian tubes against a history of an unsuccessful induced abortion and severe illness are highly suggestive of a uterine rupture resulting in secondary implantation on the broad ligament. This is probably the first case that shows an abdominal pregnancy can result from unsuccessful induced abortion. In the countries where abortion is not permitted, patients with low socioeconomic status are prone to the dangerous consequences of illegal attempts to induce abortion. Close observation and special follow-up care are necessary in such cases